Causes

The recipient's immune system responds to some transfusions by directing an immune response to the proteins in the donor's blood. Nonimmune factors are involved when the blood or components are handled, stored, or administered improperly. The most dreaded reaction is the hemolytic reaction, which occurs when the donor's blood does not have ABO compatibility with the recipient's.

Individuals at greatest risk for transfusion reactions are those who receive massive blood transfusions. The transfusions may be administered over a short period of time, such as with trauma victims with severe blood loss or recipients of liver transplants. Individuals who receive a great number of transfusions throughout a more extended period of time, such as leukemia patients, are also at greater risk. Over time, they develop more and more protective antibodies after each unit of blood is received. Eventually, they carry so many antibodies in their systems that they react much more readily than a person who is transfusionnaive.

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